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July 2005 Issue
Dem Bones
by Michael Fick
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Our skeletons provide support, mobility, armor, and a storehouse for minerals. Driven by growth, genetics, hormones, stresses, nutrition, and mineral deposition and withdrawal, bones are continuously replaced every decade or so even in adults. Unhealthy bones can fail at any of their functions, with fractures having the most important consequence since they can result in disability and even premature death. Without proper nutrition or load-bearing activity (or with smoking or heavy drinking), bone mass and strength decline, and often the first warning of osteoporosis -- porous, honeycombed, brittle bones -- is a fracture a healthy bone wouldn’t have incurred with the same trauma.

Each year about 1.5 million people suffer an osteoporosis-related fracture, many of which lead to a downward spiral in physical and mental health. Half of women over 50 will have an osteoporosis-related fracture in their lifetime, with risk of fracture increasing with age. Mortality increases by 300-400% among hip fracture patients within 3 months after the fracture, and 20 percent of senior citizens who suffer a hip fracture die within a year. Many fracture victims become isolated and depressed, paralyzed by the fear of falls and additional fractures. Spine fractures are especially tough to diagnose and treat, yet are often our first realization that we have osteoporosis unless our primary care physician is far more aware than most doctors about bone health.

Unless we patients, our doctors, and the whole medical profession change our acts, our aging population, lazier lifestyles, and junk food diets will lead to half of Americans over the age of 50 having osteoporosis or being at high risk for it by 2020 and our hip fracture incidence doubling or tripling by 2040. [I’ll bet today’s youth’s electronic lifestyle and horrible diet will compound the picture dramatically.]

When a kid falls out of a tree and suffers a routine fracture, it hurts for a few days, then gives way to increased attention, a few autographs, some itching, a really neat smell, and maybe a missed sports season. It’s a symptom of juvenile judgment or overzealousness, not poor health. They fuhgheddaboutit and move on.

When a man stands on the toilet lid and the lid breaks, letting his full weight shove his ankle ‘round the bend (it really happened), the fracture will heal more slowly, and the months of limping may induce other musculoskeletal problems. The hassle is much greater, the extra attention is less fun, the complications can last for many months, but it ultimately heals and it portends nothing.

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